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Pathway 3 Plan Guide

For the development and verification of Pathway 3 clinical mentorship plans

As an International Organisation, IBLCE uses British English in its publications.

Table of Contents
This guide provides information about how to develop a Pathway 3 Plan. It is not intended as a guide
about how to apply for the IBLCE exam. For more information about applying for the exam, please
consult the Candidate Information Guide.
What is IBLCE? .
Contact Information ..
Purpose of this Guide
Key Dates ..
Application and Other Related Forms
Applying for the Exam ..
Directly Supervised Clinical Practice
Phase 1 .
Phase 2 and 3 ..
Record Keeping ..
Applicant Responsibilities ..
Find a Mentor .
Mentor Responsibilities
CERPs for Mentors
Pathway 3 Plan Development .
Alternative Learning Activities
Ongoing Pathway 3 Plan Evaluation
Financial Considerations .
Professional Responsibilities .
Frequently Asked Questions .

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Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

Page 2 of 10

What is IBLCE?
IBLCE, or the International Board of Lactation Consultant Examiners, is the independent
international certification body conferring the International Board Certified Lactation Consultant
(IBCLC) credential.

Contact Information
International Board of Lactation Consultant Examiners (IBLCE)
6402 Arlington Blvd, Suite 350
Falls Church, Virginia 22042
www.iblce.org
IBLCE has offices in Austria, Australia and the United States. You may reach the IBLCE office
that serves your country of residence by using the form found on the Contact IBLCE page of the
IBLCE website.

Purpose of this Guide


Pathway 3 is distinguished from the other IBLCE exam eligibility pathways by requiring the
applicant to complete a clinical practice mentorship under the direct supervision of recertified
IBCLC certificants who serve as mentors. Individuals who want to follow Pathway 3 must first
submit a plan to IBLCE for how they will complete the required directly supervised clinical
practice hours in lactation and breastfeeding care.
Before the directly supervised clinical practice mentorship begins, IBLCE must verify the
certification status of the IBCLC certificants who will serve as mentors. The purpose of this
guide is to assist individuals in developing their Pathway 3 Plans.

Key Dates
Pathway 3 Plan verification is valid for 5 years. Individuals with verified Pathway 3 Plans must
meet all IBLCE exam eligibility requirements in place at the time of applying for the exam.

Application and Other Related Forms


The Pathway 3 Plan application form can be found on the IBLCE website. Other forms related to
Pathway 3 may also be downloaded from the IBLCE website. These forms can be found on the
IBLCE Documents page of the Resources section of the IBLCE website.
Plans must be verified by IBLCE before the applicant begins to accumulate the required
minimum of 500 directly supervised clinical practice hours.
IBLCE will send notification of Pathway 3 Plan verification by email. Please allow 2 weeks for
verification of your Pathway 3 Plan to be completed.
Pathway 3 Plan applications may be submitted at any time. There is no specific application
deadline. There is a fee for application verification. This fee is noted on the application form.

Applying for the Exam


In addition to a minimum of 500 hours of directly supervised clinical practice in lactation care,
Pathway 3 applicants must also complete education in the health sciences and education that is
specifically about human lactation and breastfeeding. For more information about the Health
Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

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Sciences Education and Lactation Specific Education requirements, please consult the
Candidate Information Guide, which can be found on the IBLCE Documents page of the
Resources section of the IBLCE website.
Important! Application for the IBLCE exam must occur within the 5 years immediately following
verification of the Pathway 3 Plan.

Directly Supervised Clinical Practice


Pathway 3 clinical practice hours must be directly supervised by mentors who are currently
certified IBCLC certificants in good standing who have recertified at least once. Direct
supervision is defined as a gradual, three-phase process that:
1. Begins with observation of the IBCLC mentor at work.
2. Moves to clinical practice experience under the direct observation of the IBCLC mentor
(i.e. the IBCLC mentor must be in the room with the applicant) until the skill is mastered.
3. Culminates with independent practice by the applicant with the IBCLC mentor physically
nearby to assist if needed.
Important! IBCLC certificants providing direct supervision must be physically nearby
and able to step in if the Pathway 3 applicant needs assistance. IBCLC mentors may
not supervise via the phone.
Only those hours spent completing directly supervised clinical practice that involves direct
interaction with breastfeeding mothers and children may be counted toward the required 500
hours minimum. Hours of clinical experience obtained prior to Pathway 3 Plan verification; hours
obtained through work or volunteer experience; hours observing IBCLC certificants at work
and/or hours spent in completing alternative learning activities may not be counted toward
fulfilling Pathway 3 requirements.

Phase 1
Observation of the IBCLC mentor(s) at work must occur before the Pathway 3 applicant
works directly with breastfeeding families.
At the discretion of the supervising IBCLC, this observation may occur in conjunction
with written assignments or coursework and may be undertaken before the Pathway 3
Plan is verified.
Clinical observation of the IBCLC mentor does not count toward the minimum
requirement of 500 directly supervised clinical practice hours.

Phases 2 and 3
Practice obtained under phases 2 and 3 of direct supervision may be counted toward the
required 500 hours of directly supervised clinical practice. The directly supervised clinical
practice may be undertaken only after the Pathway 3 Plan is verified by IBLCE.
Please Note: Due to the need to observe mentors and/or complete alternative learning
assignments, completion of the Pathway 3 Plan will require more than 500 hours of the
applicants time. This should be taken into consideration when planning for IBLCE exam
application.
Actual practice by the applicant is required in Phases 2 and 3 of direct supervision. This
means that the applicant provides the care either with the IBCLC mentor in the room or
nearby to provide assistance. IBLCE recommends that the directly supervised clinical
practice hours be obtained in at least 3 settings.
Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

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Hours accumulated in phases 2 and 3 may be counted toward the minimum


requirement of 500 directly supervised clinical practice hours.
The Pathway 3 Plan must be verified before the applicant can count the Phase 2
and 3 directly supervised clinical practice hours.
The applicant should not be allowed to practice independently (Phase 3) until the
IBCLC mentor(s) have determined that the applicant knows the limits of her/his
knowledge and skill. Knowing when to ask for help is essential to the applicants
demonstration of the specialized knowledge required of IBCLC certificants.
Directly supervised clinical practice hours must be accumulated in every duty listed
on the Clinical Competencies for the Practice of International Board Certified
Lactation Consultants.
o The number of directly supervised clinical practice hours accumulated in
every duty must be recorded on the Pathway 3 Clinical Practice Hours Report
and verified by the Chief Mentor.

It is important that applicants practice in settings that will give them an opportunity to
work with mothers and children across the chronological spectrum from pre-conception
through weaning. IBLCE recommends that the directly supervised clinical practice hours
be obtained in at least 3 settings. Most of the applicants experience should be obtained
by providing direct in-person care. Telephone and email counseling should be kept to a
minimum.

Record Keeping
It is important to keep accurate records of your directly supervised clinical practice
hours. When applying for the IBLCE exam, your application may be randomly chosen for
audit. If your exam application is audited, you will be required to submit additional
documentation. Keep an accurate record of your clinical practice by using the Pathway 3
Time Sheet and the Pathway 3 Directly Supervised Clinical Practice Hours Report.
These forms can be found on the IBLCE website on the IBLCE Documents page of the
Resources section.

Applicant Responsibilities
Pathway 3 applicants must:
Locate and contract with recertified IBCLC certificants who will serve as mentors and
choose one IBCLC to serve as the Chief Mentor.
o Please Note: IBLCE does not maintain a list of IBCLC certificants willing to be
mentors and due to restrictions in the IBLCE Privacy Policy, IBLCE staff is not
able to provide assistance in locating mentors. Pathway 3 applicants are advised
to network within their community to locate experienced IBCLC certificants who
are willing to be mentors.
o Recommendation: Contracting with more than one mentor is advisable and
gives the applicant the advantage of observing and learning from more than one
experienced IBCLC.
Establish a business relationship with the IBCLC certificants who will serve as mentors.
o Please Note: Cost of mentorship varies and is part of the business relationship
between the applicant and the mentors. IBLCE is not responsible for the terms of
this business relationship.
Meet the mentors or the practice settings requirements regarding professional liability
insurance, immunization certificates, health exam, etc.
Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

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Notify IBLCE in writing if for any reason the applicant and/or mentor decide to terminate
the plan prior to completion or if it becomes necessary to add or change mentors.
o If adding or changing mentors becomes necessary, it is the applicants
responsibility to notify IBLCE of the change and obtain a completed Mentor
Agreement Form for any new mentors. The Mentor Agreement Form can be
found on the IBLCE website on the IBLCE Documents page of the Resources
section.

Finding a Mentor
Applicants must locate and contact potential mentors directly. At present, there is no central
source for such information. IBLCE staff cannot provide Pathway 3 applicants with the names
and contact information of potential mentors in their community.
One of the best ways to locate a mentor is by networking in your community. Become involved
in your local lactation consultant association and breastfeeding coalition. Contact the lactation
department at your local hospital and inquire about IBCLC certificants in private practice in your
vicinity. The La Leche League group in your area and attending professional conferences and
workshops are other sources of referrals.

Mentor Responsibilities
One mentor must agree to serve as the primary supervisor (Chief Mentor) of the Pathway 3
Plan. The Chief Mentor is responsible for:
Creating and executing a Pathway 3 Plan which covers all of the duties listed on the
Clinical Competencies for the Practice of International Board Certified Lactation
Consultants.
Working together with the applicant to complete the Pathway 3 Plan Application form.
Securing the practice settings in which the applicant will obtain the directly supervised
clinical practice hours.
Supervising the other mentors who are providing direct supervision of the applicants
clinical practice.
Reporting to IBLCE the percentage of time each mentor provided direct supervision to
the Pathway 3 applicant. This report must be submitted when the Pathway 3 Plan is
completed and is for the purpose of awarding Continuing Education Recognition Points
(CERPs) to mentors.
IBCLC certificants who serve as Pathway 3 mentors are expected to demonstrate and
model the highest professional standards. Their commitment must extend beyond the
mother-baby dyad to teaching the Pathway 3 applicant under their supervision. Each
Pathway 3 mentor must:
Be a currently certified IBCLC in good standing who has recertified at least once.
Complete and submit a Pathway 3 Mentor Agreement Form to the applicant.
Provide a period of time during which the Pathway 3 applicant observes their practice
before allowing the applicant to provide hands-on care to breastfeeding families.
Directly supervise the applicants clinical practice and determine the degree to which the
applicant has mastered the clinical skills being practiced before permitting the applicant
to practice independently.
Log the clinical practice hours that the applicant has accumulated under their direct
supervision by completing and signing a Pathway 3 Time Sheet.

Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

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Assign additional learning activities, reading and/or written assignments to the applicant,
as needed.
Provide a reference for the Pathway 3 applicant, upon request.

Please Note: Relatives of the Pathway 3 applicant may not serve as mentors. It is a
conflict of interest for a relative of the Pathway 3 applicant to be that applicants
mentor.

CERPs for Mentors


IBCLC certificants who serve as mentors for approved Pathway 3 Plans may receive
CERPs for their service. For the purposes of CERP allocation, each Pathway 3 Plan is
eligible for a total of 25 L-CERPs. Over any given 5-year period of time, IBCLC certificants
may acquire up to a maximum of 50 L-CERPs for their service as mentors to applicants who
complete their approved Pathway 3 Plan.
CERPs will be allocated on the basis of the percentage of time each mentor provided direct
supervision to the applicant following Pathway 3. The Chief Mentor will be responsible for
reporting these percentages to IBLCE. Based upon this report, IBLCE will notify the Chief
Mentor of the number of CERPs each mentor earned.

Pathway 3 Plan Development


The Chief Mentor is expected to work with the Pathway 3 applicant to develop a plan for
covering all of the duties listed on the Clinical Competencies for the Practice of International
Board Certified Lactation Consultants. Making provisions for practice in several settings is
important to well-rounded education in the clinical competencies. IBLCE recommends that
applicants obtain clinical practice in at least 3 different practice settings.
Some duties will be more amenable to clinical practice than others and some situations will
require more time than others. The assignment of other activities such as literature research or
watching instructional videos may be needed in order for applicants to be exposed to all of the
clinical skills. These alternative learning activities may be necessary but ONLY those hours
spent in directly supervised clinical practice that involves direct interaction with breastfeeding
mothers and children may count toward the required minimum of 500 hours.

Alternative Learning Activities


These alternative learning activities are intended as suggestions to applicants and mentors.
Pathway 3 Plans may include other learning activities agreed upon by the mentor and
applicant.
Attend a childbirth conference, a seminar conducted by a professional association, or
sessions presented by a lawyer, a dietician, or a human relations counselor.
Study the anatomy and physiology of the breast in detail, including how milk is
synthesized.
Learn about infant oral anatomy and development (or other topics) and write a report.
Make a presentation to your colleagues on the biochemistry of human milk, or a similar
challenging topic.
Observe the interaction of a mother and baby during the first two hours after birth.
Compare the baby of a mother who used no medication during labor with the baby of a
mother who used pain relief medication.
Attend a variety of mother-to-mother support meetings to observe mothers and babies
Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

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and to learn more about the wide range of normal breastfeeding experiences. Observe
the group counselors, listen, ask questions, practice ethics, etc.
Observe the developmental milestones of babies and young children in a casual setting.
You might spend time at a playground, a playgroup or a mother support gathering
watching the interactions of mothers and babies/toddlers. Estimate the ages of
babies/toddlers by observing their developmental activity level.
Take a professional ethics class or attend a seminar on health privacy issues relevant to
your country, community or practice setting.
Do a study of the normal growth, development and breastfeeding behavior of a single
baby over a six-month period.
Join a study group that critically reads peer-reviewed journal articles on breastfeeding to
learn more about research techniques and evidence-based practice.
Attend a Baby Friendly Hospital Initiative (BFHI) course. Review hospital practices to
see how breastfeeding-friendly they are. What types of breastfeeding problems might
arise as the result of poor hospital practices? How might these problems be prevented?
Join your local professional lactation consultant organization for support, information and
educational opportunities.
Complete tests, quizzes, and/or projects related to reading or clinical practice hours.
Participate in role playing exercises.
Complete hypothetical charting exercises and practice writing reports to the primary
health care provider.
Complete a series of training sessions in multicultural counseling skills.
Communicate with other health professionals, both supportive of and resistant to
breastfeeding programs and practices.
Discuss the difference between telephone counseling and in-person consultation, with
particular emphasis on the fine art of telephone triage and recognizing critical situations.
Dialogue with your mentors about difficult challenges such as helping mothers of babies
with disabilities, unexpected birth trauma, neonatal death, child abuse, medical
emergencies, etc.
Participate in discussions about how to work with other health care professionals as an
effective, respected member of the lactation care team.

Ongoing Pathway 3 Plan Evaluation


Periodic evaluation is essential to the Pathway 3 Plan. Challenging situations such as poor work
habits, unprofessional behavior, or poor clinical knowledge or counseling skills may arise
between applicant and mentor. The Pathway 3 applicant and mentor(s) should have regular
evaluation meetings.
Whether the evaluation occurs daily, weekly, bimonthly, or monthly, establishing a schedule of
meetings for the purpose of working through such challenges is important. Although evaluation
time cannot be counted toward the directly supervised clinical practice requirement, it is
imperative that time for evaluation be planned.

Financial Considerations
Pathway 3 applicants are responsible for locating and contracting with IBCLC mentors and one
mentor must agree to serve as Chief mentor. IBLCE strongly recommends that the applicant
and mentor sign a written agreement before the mentoring services begin.

Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

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IBLCE is not able to provide assistance in locating mentors. Applicants are


advised to network within their community to locate recertified IBCLC certificants
willing to serve as mentors.
The agreement reached, and fulfillment of it, is the sole responsibility of the
parties involved. IBLCE cannot serve as a negotiator, arbitrator, legal counsel, or
collection agency for either the Pathway 3 applicant or mentor.

Cost of mentorship varies and is part of the business relationship between the applicant and
her/his mentor(s). The Pathway 3 applicant is responsible for obtaining professional liability
insurance, immunization certificates, health exam, etc. required by the mentor and/or practice
setting. As is the case in preparing for any career, the Pathway 3 applicant must expect to incur
expenses such as, but not limited to, textbooks, insurance, seminars and workshops, and
mentors fees.

Professional Responsibilities
Pathway 3 applicants are expected to adhere to certain basic principles of professional and
ethical practice, including but not limited to:
Conduct herself/himself in a professional manner at all times, adhering to all principles of
the IBLCE Code of Professional Conduct for International Board Certified Lactation
Consultants.
Ensure that proper health, safety and insurance standards are met at all practice
settings
Complete written work promptly and in compliance with the mentors requirements
Obtain permission from the mother to observe, assist and/or provide lactation care
Keep accurate records of the time spent completing the Pathway 3 plan
Abide by any requirements of the clinical placement site where the directly supervised
clinical practice in lactation and breastfeeding care is obtained

Frequently Asked Questions


Can I get credit for clinical practice accumulated prior to verification of my plan or may I
use my on-the-job experience? No. Your plan must be verified before you begin accumulating
the directly supervised clinical practice hours and you may not combine on-the-job experience
with directly supervised experience in order to meet the 500 hour requirement. You may
observe your mentor(s) before the plan is verified but you must wait for notification that your
plan has been verified to begin counting the directly supervised clinical practice hours.
What is the Pathway 3 Application deadline? Pathway 3 Plan applications may be submitted
at any time. There is no specified deadline.
Can any portions of the Clinical Competencies for the Practice of International Board
Certified Lactation Consultants be omitted? No. You are expected to demonstrate to your
mentor that you are skilled in all the clinical competencies.
Where can I obtain the clinical experience? Hours may be accumulated in any setting which
affords the opportunity for hands-on, directly supervised clinical practice. Locations may include,
but are not limited to, hospitals, birthing centers, physicians offices, public health clinics and
private lactation consultant practices. IBLCE recommends that you obtain experience in at least
3 different settings.
My local hospital will not permit me to provide care to their patients. What can I do? Be
sure to verify that the places where you will be working with breastfeeding mothers and babies
Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

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will allow you to provide hands-on care. Some hospitals and clinics will allow observation by
Pathway 3 applicants but will not allow the applicant to actually practice, even with the mentor
present. You and your mentor will need to work together to find appropriate clinical placement
settings that will allow you to actually provide care to breastfeeding families, not just observe
them.
Can the required minimum 500 directly supervised clinical practice hours be reduced by
experience or other means? No. All Pathway 3 applicants must complete the 500 hours of
directly supervised clinical practice minimum requirement.
Can the hours I spend observing IBCLC certificants at work be counted? No. You may
count only those hours that you have spent actually providing lactation care under the direct
supervision of your mentor(s).
Am I required to be a nurse of other health professional to qualify under Pathway 3? No.
Individuals from a broad variety of backgrounds may qualify through Pathway 3.
My mentor works in a retail store which sells and rents breast pumps. May I count the
practice hours I obtain while helping customers? No. Hours helping mothers choose which
products to purchase or rent cannot be used toward meeting the Pathway 3 requirements.
Can Pathway 3 be undertaken by anyone, anywhere in the world? Yes, with limitations.
Certain local or regional laws and regulations may require that Pathway 3 applicants meet other
requirements besides those listed in this guide. IBLCE office staff can provide you with more
information about such additional requirements. Use the form found on the Contact IBLCE page
on the IBLCE website to reach the IBLCE office that serves your country of residence.
Can an IBCLC who has not recertified at least one time be my mentor? No. All Pathway 3
mentors must be recertified IBCLC certificants.
Can additional mentors be added to my Pathway 3 Plan? Yes. Once your pathway 3 Plan is
approved, it is possible to add additional mentors Mentor Agreement Form from your new
mentor(s)

Copyright 2013, International Board of Lactation Consultant Examiners. All rights reserved.

Pathway 3 Plan Guide


Last updated August 2013

www.iblce.org

Page 10 of 10